Delgado GE, Krämer BK, Siekmeier R, et al. - Given that atherosclerosis is preceded by endothelial dysfunction and smoking represents a well-recognized factor for the development of endothelial dysfunction, researchers determined how circulating markers of endothelial function are influenced by smoking and if the potential use of these markers to estimate cardiovascular risk may be affected by such influences. Participants (n = 1,926) were selected from a prospective case-control study, the Ludwigshafen Risk and Cardiovascular Health, which included patients who had coronary angiography with a median mortality follow-up of 10.6 years. Higher levels of sICAM-1, sE-selectin sP-selectin but lower levels of sL-selectin and sVCAM-1 were found in smokers vs never-smokers. For levels of sICAM-1, sVCAM-1 and von Willebrand, a direct link with death was identified irrespective of smoking. Findings revealed that the level of circulating markers of endothelial function was altered by smoking. Smokers had reduced sL-selectin, which was inversely related to risk and could afford a valuable marker to improve risk prediction.